Inspection on 17/11/08 for Two Trees

This inspection was carried out on 17th November 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Two Trees 07/12/06

Two Trees 24/11/05

Two Trees 17/05/05

Two Trees 16/12/04

Two Trees 24/06/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Two Trees 33 Milehouse Road Milehouse Plymouth Devon PL3 4AF The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kim Fowler Date: 1 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 36 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 36 Information about the care home Name of care home: Address: Two Trees 33 Milehouse Road Milehouse Plymouth Devon PL3 4AF 01752561189 01752558181 twotrees@dsl.pipex.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs June Ann Gliddon,Mr Roger Festin Gliddon,Mrs Paula Marie Pillage Name of registered manager (if applicable) Mrs Paula Marie Pillage Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 28 28 0 0 care home 28 learning disability physical disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) Physical disability (Code PD) The maximum number of service users who can be accommodated is 28 Date of last inspection 1 7 1 2 2 0 0 6 Care Homes for Adults (18-65 years) Page 4 of 36 A bit about the care home Two Trees is owned by Mr and Mrs Gliddon, and Mrs Pillage, who is also the Registered Manager. On street parking is available at the front of the home. Twenty-eight people with learning disabilities live at the home. Some people also have physical disabilities. The home is partially wheel chair accessible and has a shaft lift as well as a stair lift. The house is close to shops and the city centre. Care Homes for Adults (18-65 years) Page 5 of 36 The home has its own vehicles so people can go on trips out. One vehicle has a tail lift for wheel chairs. There is a bus stop near the home where people can take buses into the city centre or other places. People can use trains and taxis to go to other places. There are two lounge/dining rooms on the ground floor. There are also two conservatories, a music/relaxation room and a room for hairdressing. Care Homes for Adults (18-65 years) Page 6 of 36 Each person has their own bedroom. No-one has to share a bedroom. Over half of the bedrooms have en suite toilets, with many having en suite showers or baths, some of which are adapted to meet the specific needs of individuals. There are also bathrooms, showers and toilets throughout the home. There is a patio and large courtyard at the back of the house. Fees levels are between 324 pounds and 868 pounds, although these may vary depending on people’s individual needs. Care Homes for Adults (18-65 years) Page 7 of 36 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 36 How we did our inspection: This is what the inspector did when they were at the care home The inspection was carried out by one inspector who visited the home without telling anyone she was coming. She was there from 9:45am to 7:10pm on Monday 17th November 2008. Throughout this report the term “we” will be used as the report is written on behalf of the Commission for Social Care Inspection. We spoke to most people living in the home. We talked to all the staff on duty and the manager. Care Homes for Adults (18-65 years) Page 9 of 36 Five surveys were returned from people living in the home. Two professional and three relative surveys forms were also returned to us. We looked all around the home. We looked at the care records of five people who lived in the home. We looked at other records that told us how the home is run. This included staff records and health and safety records. Care Homes for Adults (18-65 years) Page 10 of 36 Before the inspection an Annual Quality Assurance assessment (AQAA) was completed by the manager. What the care home does well The home continues to decorate the home and upgrade the environment as needed. This ensures that the physical environment of the home meets individual needs and is fully accessible for all. The owners encourages staff training and development ensuring that people who live at the home receive the best possible service. The home encourages people to have outside interests including employment, voluntary work and a variety of leisure activities available inside the home and in the community. Care Homes for Adults (18-65 years) Page 11 of 36 People living in the home are able to enjoy a stimulating lifestyle with a variety of options to choose from. The home supports people to be independent and involved in all areas of daily living including housekeeping tasks and planning meals. People who needed help supported and staff support people in a relaxed and helpful way. The staff ensures that the care provided is flexible, consistent and is able to meet the changing needs of individuals. With specialist equipment provided for those who require it. Care Homes for Adults (18-65 years) Page 12 of 36 Relative surveys returned to the home wrote, Two Trees has provided my relative with the support and care necessary to give them a quality of life equal to and exceeding that expected in a happy family. What has got better from the last inspection The home has benefited from fitting a new raised bath and an overhead hoist for the benefit and comfort of one person living in the home. The home has build a pottery shed in the garden to be used by all who live in the home. Care Homes for Adults (18-65 years) Page 13 of 36 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Kim Fowler CSCI Colston 33 33 Colston Ave Bristol BS1 4AU Tel: 0117 930 7110 Fax: 0117 930 7112 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 14 of 36 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 15 of 36 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 16 of 36 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Prospective new admissions referred to the home can be assured that they will be provided with sufficient information for them to make an informed choice about living at this care home. Evidence: The file of the recent new admission to the home was examined and showed that it held a completed pre-admission assessment. This information was supported by the previous placements care plan and the placing authority provided additional information. This information is important so prospective admissions are assured that not only can their health care needs but also their physical needs are managed and met by the home. Recorded into this person file were the dates and times of trial visits to the home and included visiting the home for meals and overnight stays. The homes AQAA returned to the Commission said, A full assessment and person Care Homes for Adults (18-65 years) Page 17 of 36 Evidence: specification is taken into account when considering new residents. Care Homes for Adults (18-65 years) Page 18 of 36 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are encouraged and supported to make daily decisions about their own lives to maintain their independence. Evidence: The files for five people living at the home were examined. All five files examined held individual care plans in place and the details held on these files are needed by staff to meet individual needs. These care plans show a breakdown of the services and facilities provided by the home as well as current needs, specialist input and guidelines for staff to manage individuals. Each individual plan provide staff with the information on how to care for each person and ensure continuity in care and have been completed to enable staff to carry out their duties. All plans ensure that all aspects of health, personal and social needs will be met. The homes files and care plans were supported by the placing authority care plan and each showed that they had been reviewed regularly and updated when needed. Care Homes for Adults (18-65 years) Page 19 of 36 Evidence: Individuals are invited to attend review meetings and participate as much as possible. Observations throughout the inspection were staff assisting people to make decisions about everyday issues. This included any trips out that day and the choice for lunchtime meal. The manager stated that each person is given options about were to go on holiday or day trips and then the options available are discussed and destination chosen. The homes AQAA states that, Our care plans and risk assessments are comprehensive and are reviewed and updated regularly. Those people who were able to confirm that they choose were they went when they went out and one person said, I go to the local shops. And one survey returned to the Commission said, I go to church on Sundays. All care plans held risk assessments to cover all aspects of risk. These risk assessments included independent living skills and manual handling risk assessments with assistance on using the hoist if required. This information is important to minimise risk. One file examined showed the recent updated information required due to a recent accident and how the home is now managing this persons needs. All five surveys returned to the Commission from people living in the home ticked, Always, when asked if they are able to make decisions about what they do each day. Care Homes for Adults (18-65 years) Page 20 of 36 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people living in Two Trees can be confident that the home will promote and provide support for them to access the local community and leisure activities as much as possible. Evidence: Most of the people living at the home were spoken with and some were able to that confirm that they go out to different places and include local shops, a local disco and swimming. Staff spoken with were able to confirm that the home has its own holiday accommodation where most people go for weekend and week long trips away. Observation during the inspection were several people discussing with staff the plans for the weekend including going to the shops and what they wished to purchase with their money. Staff were observed interacting with all the people living in the home including discussions on trips, meals and general everyday issues. Care Homes for Adults (18-65 years) Page 21 of 36 Evidence: The manger confirmed that one person is involved in a local advocacy group and another works at a local department store. Several other people had information recorded into their files of the work they undertake. The home arranged different activities within the home and in the community to ensure each person has a wide range of activities. The home also employs an activity coordinator to carry out a wide range of activities within the home including art and craft. Other social activities arranged include trips to the local pub and some people attended a day centre. The home has its own mini bus and staff arranged regular trip out based on individuals preferences. Trip arranged included visiting a seaside town and a zoo. Some people were discussing a visit to see the local towns Christmas Lights. One person living at the home said, I like the trips to Butlins. The homes AQAA records under what they do well, We have an activities room and employ an activities coordinator who works Mon- Fri, 10 am- 4 pm working solely with the residents engaging them in arts and crafts, cooking, independent living skills, Communication, Ladies, computers and music groups. Evidence was recorded in the files examined of input from relatives and friends. The staff confirmed that several people have regular visits from family members and some people visit their families at home. One person said, I am visiting my mum soon and another person confirmed that their family visit them. The last two admissions had information recorded in their individual files that they see people from their previous placement. One relative said in a survey sent to the Commission, She is encouraged to maintain contact with her family. Observation throughout the day were people living in the home participating in daily routines including preparing the tables for meals. Several people were able to confirm that the staff knocks on their bedroom doors to gain entry. Observation showed several people choosing to remain in their own rooms. Information held on files is used to promote the respect, privacy and dignity of each person living in the home and the home and the grounds are assessable for wheelchair access. Everyone spoken with about the food and who were able made positive comments and several people confirmed that they go to the shops to assist with the shopping. One person said, I like the food and another stated, I can choose the food I like anytime I like. The staff confirmed that there is a menu available but it is discussed with the people living in the home regularly to change and update it as needed. The lunchtime and evening meal observed being served , Chicken curry, rice and naan Care Homes for Adults (18-65 years) Page 22 of 36 Evidence: bread or cheese salad, provided evidence that individual choices of food were offered. Further observation during this meal served provided evidence that everyone has staff support and specialist equipment if required and this promotes independence at meal times. Specialist diets are catered for and one person has information recorded on how this is managed by the home and the involvement of the Dietician and SALT. (Speech and Language Therapist). The home has a small training kitchen in the activities area to encourage and promote independent living skills for people. Care Homes for Adults (18-65 years) Page 23 of 36 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff were observed promoting individuals independence and providing good personal support promoting privacy and dignity at all times. Access to health care is maintained to promote the wellbeing of all who live in the home. Evidence: All personal support is recorded into individual care plans and these are easily accessible for staff and all rooms are single. People who require assistance with moving has a moving and handling plan and risk assessment to assist staff on how each person prefers to be supported. Each person has a health action plan in the individual file and the local Health Team assisted in producing this document. These provide information on the current health care needs of individuals and showed that changing health care needs for one individual had been changed and clearly recorded to provide staff with regular updates on how best to manage this individual. This ensures consistency in the care provided. These care plans are based on assessed needs and evidence was recorded that these are regularly reviewed and then signed. Care Homes for Adults (18-65 years) Page 24 of 36 Evidence: Guidance on personal care is clearly recorded into individual files and this ensures that staff are aware of peoples needs and will promote consistency in care. Other professionals involved in the home include the local Dementia team, Physiotherapist and District Nurses. The homes AQAA states on what they would have improved over the last 12 months, Ensured that the newly set up health action plans are maintained and updated. Observed during the inspection was one person discussing with a staff member who would assist them with their personal care needs. One person living at the home also requires specialist input and evidence was recorded that the District Nurse and Dieticians teams had assist in providing an assessment and input to the home to ensure this persons changing needs are met. One person had recently had an admission to hospital but was now home. The manager confirmed that the home had reviewed this persons risk assessment form to ensure staff are aware on how to meet this persons changed needs. The medication system was checked during this inspection and found to be well recorded and documented. Staff designated to administer medication have received medication training and one staff member confirmed that they had received medication training. One relative survey returned to the Commission said, My relatives health needs are met by Two Trees or referred to his doctor or hospital as appropriate. Care Homes for Adults (18-65 years) Page 25 of 36 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people living at Two Trees can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. Evidence: The home has a complaints procedure in place and is clearly displayed on the homes notice board and is also available in the homes Statement of Purpose and Service Users Guide. This information included how to contact the CSCI and the process of how a complaint is dealt with including timescales. The Commission had received no complaints. The home has recently received one complaint and the local authority have been involved in the investigation. This is currently ongoing, however the home feels that this complaint will not be upheld. Many of the people living at the home were spoken with and several were aware that they could make a complaint. One survey returned said, I would go to the staff and I would know they would help me. The manager confirmed that all staff have completed the POVA (Protection of Vulnerable Adult) training with a Training company. Several staff were able to confirm that they had received the Safeguarding training via the local training company. Care Homes for Adults (18-65 years) Page 26 of 36 Evidence: The homes AQAA states, To continue with our programme of staff training in protection of vulnerable adults and make visitors aware of the complaints procedure. Care Homes for Adults (18-65 years) Page 27 of 36 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Two Trees continues to update and upgrade a clean and suitable environment for its stated purpose and people living at the home can be assured that they will live in a comfortable home that is regularly maintained. Evidence: A full tour of the premises showed that the home is suitable for its stated purpose. The home is well kept, safe and accessible for all the people currently living at the home. Some people were able to confirm that they found the home comfortable, clean and warm. One person spoken to said, I like living here. Individual bedrooms showed that peoples rooms contained personal items including furniture, ornaments and pictures that reflect their personality and interests. All bedroom doors now have locks fitted; however some people choose not to hold keys. Risk assessments are held on individual files reflecting these choices. Appropriate disability equipment is provided in the home, and these include a passenger lift, overhead hoists and wheelchairs. This equipment provides the people living at the home with a building that is appropriately adapted to meet their needs. A relative survey sent to the Commission says, Has a happy atmosphere. Care Homes for Adults (18-65 years) Page 28 of 36 Evidence: The recent improvements to update the home have included, fitting a raised bath and overhead hoist to meet the needs of one person living in the home and a newly fitted pottery workshop in the garden for everyones use. This will be organised and assisted by the homes activities coordinator. The process for the removal of clinical waste was discussed and was satisfactory dealt with and one staff member confirmed they had completed infection control training. Other staff confirmed that the home provided disposable aprons and gloves for their protection. And the manager confirmed that most staff have completed an infection control course and the premises were clean, hygienic and free from offensive odours and the laundry facilities were separate. The homes AQAA says, Involved more of our senior staff with the infection control group held in Plymouth. Care Homes for Adults (18-65 years) Page 29 of 36 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training is carried out regularly for all staff to ensure that all assessed needs of the people living at the home are met. Evidence: The staff were observed throughout the inspection responding sensitively and respectfully to each person living in the home and thus were able to use their knowledge of individuals to encourage choice and independence were possible. All staff were observed to be friendly, good-natured, courteous and respectful at all times. They interacted well with the people living in the home and some of the activities sessions observed showed that the staff and the people living in the home having fun in a relaxed friendly atmosphere. Some of the people living in the home were able to confirm, as were the staff spoken with, that there were sufficient staff on duty to met the current needs of people living in the home. On the day of the inspection there was the manager, a deputy manager, one senior care staff, 6 care staff, a cook, 3 cleaners, a driver, a handyman and an activities coordinator. The home also provides waking night staff and an on-call system Care Homes for Adults (18-65 years) Page 30 of 36 Evidence: for the management. Observation showed that the staff members on duty were aware of individuals needs and how best to support them. Some of the people living in the home were able to say that the staff team were very good and it was evident that there was a good rapport between everyone living and working in the home. Examination of staff files showed that all staff had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. Discussions with manager and the staff showed that all staff participate in and update training course when needed. The training recorded in individuals files show that induction, adult protection, first aid, health and safety, fire safety, medication, food hygiene, National Vocational Qualifications (NVQs) and courses related specifically to working with people with learning disabilities is regularly undertaken. These include course on epilepsy, dementia and total communication skills. The home also has a Deprivation of Liberty course arranged. The homes AQAA records that in the next 12 months they will, Continue to encourage staff to gain qualifications. Several staff members were spoken with during this inspection and all confirmed regular training was offered. These staff also felt that they were able to express their view at staff meetings held in the home. Regular consultation with staff ensures staff can contribute to the running of the home and are aware of the homes aims and objectives, philosophies of care and promotes consistency and improvement. One staff member said of the staff team, Good staff team and supportive. One person living in the home said, The staff take me out. A relative survey returned to the Commission said, The residents are treated as individuals and this is quite remarkable when all individuals are different. A health care professional survey said, The care staff work well as a team. Care Homes for Adults (18-65 years) Page 31 of 36 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The management of this home is very good and ensures that records are effectively maintained. And the staff team are well trained to meet the needs of people living at the home. Evidence: The Registered Manager, Paula Pillage continues to manage the home and has done for a number of years. The manager has completed a level 4 National Vocational Qualification (NVQ) in Care and has completed the Registered Managers Award, thereby demonstrating that she keeps herself up to date with current good practice in social care The manager also holds a full 4-day 1st Aid training qualification and also has completed training in POVA and medication. Discussions with the people living in the home and the staff on duty confirmed that the manager is approachable and is highly thought of by all spoken with. Care Homes for Adults (18-65 years) Page 32 of 36 Evidence: The home held completed quality assurance surveys sent by the home. All show positive comments included comments from GP, relatives and other Health Care professionals. One GP wrote, A well run caring home and a relative said, I cant speak highly of Two Trees. The staff are loving, caring and well trained. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Gas and electrical appliances were being routinely serviced and checked. On the day of the inspection the home was being fitted with a new gas boiler. The fire protection system was well maintained. Maintenance checks are being carried out. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies and many staff were attending a fire safety training course during the inspection. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Care Homes for Adults (18-65 years) Page 33 of 36 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 34 of 36 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 35 of 36 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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